Predictors of frailty trajectories among people with HIV.

Objective: This study aimed to estimate the latent frailty trajectories and identify corresponding predictors (socio-demographic, HIV-related, comorbidities, and behavioral) among a cohort of PWH.

Design: Longitudinal observational study using latent class growth modeling.

Methods: Nine hundred seventy-six PWH aged 40 years and older with frailty measured from at least two visits within the ACTG HAILO cohort were included. Frailty components included weakness, physical activity, weight loss, exhaustion, and slowness. Latent class growth models were estimated to capture change in frailty over time; multinomial logistic regression was used to estimate associations between predictors and frailty trajectory class.

Results: At baseline, participants were M = 51.5 years old (SD = 7.5), 81% male (n = 783), 48% White non-Hispanic (n = 461), and 20% Hispanic (n = 195). Latent class growth models identified three frailty trajectories: Sustained robustness (n = 811; 83%), Worsening frailty (n = 79; 8%), and Frailty improvement (n = 86; 9%). Older age, race, sex at birth, select comorbidities (cardiovascular disease, depression, type 2 diabetes), and behavioral characteristics (physical activity, smoking, and alcohol) were associated with fluctuations in frailty trajectories over time (p < 0.05).

Conclusions: Modifiable factors such as managing comorbidities and promoting physical activity present ideal opportunities for future interventions to prevent or slow the progression of frailty.